Surgical Management of a Recurrent Orbit-Eroding Mucocele Associated With Frontal-Ethmoidal Sinus Inverted Papilloma

Area of Science:

• Otolaryngology
• Neurosurgery
• Ophthalmology

Background:

• Orbit-eroding mucoceles associated with inverted papillomas are infrequently documented.
• Surgical management of such complex cases presents unique challenges, especially when craniotomy is declined.

Observation:

• A patient presented with a fronto-ethmoidal sinus inverted papilloma causing a recurrent orbit-eroding mucocele.
• The patient opted against a craniotomy for surgical intervention.

Findings:

• A combined surgical strategy involving frontal endoscopic sinus surgery and external sub-brow anterior orbitotomy was employed.
• This approach facilitated exploration, drainage, and excision of both the mucocele and the inverted papilloma.
• Stereotactic navigation guided the precise execution of the combined transnasal endoscopic and external sub-brow anterior orbitotomy.

Implications:

• This case highlights the efficacy of a combined endoscopic and external surgical technique for managing orbit-eroding mucoceles secondary to inverted papillomas.
• The described surgical approach offers a viable alternative to craniotomy, preserving orbital and dural integrity.
• Effective management strategies are crucial for preventing recurrence and preserving visual function in these rare conditions.